Correction for GOLDSTEIN 2020-1134 Free

An error occurred in the article by Goldstein ND et al, titled “State and Local Government Expenditures and Infant Mortality in the United States” published in the November 2020 issue of Pediatrics (2020;146(5):e20201134; doi:10.1542/peds.2020-1134).

On page 1, under the Results section of the abstract, this reads “State and local governments spend, on average, $9 per person. A $0.30 per-person increase in environmental spending was associated with a decrease of 0.03 deaths per 1000 live births, and a $0.73 per-person increase in social services spending was associated with a decrease of 0.02 deaths per 1000 live births.”

This should have read “State and local governments spend, on average, $9,030 per person. A $300 per-person increase in environmental spending was associated with a decrease of 0.03 deaths per 1000 live births, and a $730 per-person increase in social services spending was associated with a decrease of 0.02 deaths per 1000 live births.”

On pages 3 to 4, under the Results section of the main text, the first 2 paragraphs read “From 2000 to 2016, infant deaths per 1000 live births ranged from a low of 3.5 (VT, 2016) to a high of 13.7 (Washington, DC, 2005), with an overall mean of 6.6 (SD = 1.5) (Fig 1). The IMR was more than twofold higher among Black infants (mean = 12.2) than white (mean = 5.5), Asian American (mean = 5.1), or Hispanic (mean = 6.0) infants. The IMR was highest among mothers aged <20 years (mean = 9.7) and lowest among mothers aged 30 to 39 years (mean = 5.7). Comparisons among national, regional (northeast, south, Midwest, and west), and state IMRs overall and by race, ethnicity, and maternal age group are shown in Supplemental Figs 5–13. There was wide variation in state and local government expenditures (Fig 1, Supplemental Table 2), with a mean total spending of $9.03 (SD = $2.86) per person, per state. Expenditures on education averaged the highest among our categories (mean = $2.63; SD = $0.61), followed by social services (mean = $2.03; SD = $0.73) and environmental services (mean = $0.59; SD = $0.30) per person, per state.

Results from the adjusted regression models suggest that increases in total, environmental, and social services spending over time may reduce IMRs during the studied years (Fig 2). A $0.30 (1 SD) increase in environmental spending per person was associated with a decrease of 0.03 deaths per 1000 live births (95% confidence interval [CI]: −0.04 to −0.01), and a $0.73 (1 SD) increase in social spending per person was associated with a decrease of 0.02 deaths per 1000 live births (95% CI: −0.04 to −0.01). Although point estimates suggest that increased spending reduced the IMR among Black children and had the unintended consequences of increasing the IMR among Asian American children, the associations were not statistically significant, with all CIs crossing 0. Infants born to mothers aged <20 years had the single greatest benefit from an increase in social and environmental expenditures compared with all other age groups. In particular, a $0.30 (1 SD) increase in environmental spending per person was associated with a decrease of 0.08 deaths per 1000 live births among mothers aged <20 years (95% CI: −0.13 to −0.03), and a $0.73 (1 SD) increase in social spending per person was associated with a decrease of 0.06 deaths per 1000 live births among mothers aged <20 years (95% CI: −0.10 to −0.02). State-level poverty rate was an independent risk factor for IMR across the majority of models, after accounting for expenditures and year-to-year differences (Supplemental Fig 14).”

This should have read “From 2000 to 2016, infant deaths per 1000 live births ranged from a low of 3.5 (VT, 2016) to a high of 13.7 (Washington, DC, 2005), with an overall mean of 6.6 (SD = 1.5) (Fig 1). The IMR was more than twofold higher among Black infants (mean = 12.2) than white (mean = 5.5), Asian American (mean = 5.1), or Hispanic (mean = 6.0) infants. The IMR was highest among mothers aged <20 years (mean = 9.7) and lowest among mothers aged 30 to 39 years (mean = 5.7). Comparisons among national, regional (northeast, south, Midwest, and west), and state IMRs overall and by race, ethnicity, and maternal age group are shown in Supplemental Figs 5–13. There was wide variation in state and local government expenditures (Fig 1, Supplemental Table 2), with a mean total spending of $9030 (SD = $2860) per person, per state. Expenditures on education averaged the highest among our categories (mean = $2630; SD = $610), followed by social services (mean = $2030; SD = $730), and environmental services (mean = $590; SD = $300) per person, per state.

Results from the adjusted regression models suggest that increases in total, environmental, and social services spending over time may reduce IMRs during the studied years (Fig 2). A $300 (1 SD) increase in environmental spending per person was associated with a decrease of 0.03 deaths per 1000 live births (95% confidence interval [CI]: −0.04 to −0.01), and a $730 (1 SD) increase in social spending per person was associated with a decrease of 0.02 deaths per 1000 live births (95% CI: −0.04 to −0.01). Although point estimates suggest that increased spending reduced the IMR among Black children and had the unintended consequences of increasing the IMR among Asian American children, the associations were not statistically significant, with all CIs crossing 0. Infants born to mothers aged <20 years had the single greatest benefit from an increase in social and environmental expenditures compared with all other age groups. In particular, a $300 (1 SD) increase in environmental spending per person was associated with a decrease of 0.08 deaths per 1000 live births among mothers aged <20 years (95% CI: −0.13 to −0.03), and a $730 (1 SD) increase in social spending per person was associated with a decrease of 0.06 deaths per 1000 live births among mothers aged <20 years (95% CI: −0.10 to −0.02). State-level poverty rate was an independent risk factor for IMR across the majority of models, after accounting for expenditures and year-to-year differences (Supplemental Fig 14).”

On page 13 of the Supplemental Information, Supplemental Table 2 included errors in the dollar amounts. Each dollar amount should have been multiplied by 1000. A corrected Supplemental Table 2 has been provided.